Tuesdays With Morrie Essay

First minute after drop, pulse 54. Second minute 52. Third 39. Fourth 20.

“it appears that the inventor is dead, and that his estate took out the patent since this great benefactor should have been, by the use of his preparation, immune to practically all diseases, he must have died of senility, although this seems hardly to have been the case ”and held. “assuredly granting patents on such claims ought to be sufficient to show the need of a change in the methods of granting patents-- at least of the methods governing the issuance of patents for medicinal products ”we submit, that had the dewritingment of the government entrusted withthe enforcement of the federal food and drugs act been consulted as tothe claims of this patent, it would probably have advised that, if theabsurd and palpably fraudulent claims set forth in this application fora patent were made on the label of a preparation of creatinin offeredfor sale in interstate commerce or in the district of columbia, thevendor would be prosecuted in 1914 there was issued u s patent no 1, 086, 339 here the“inventor” declared. “it is the object of my invention to destroy parasitic micro-organisms, writingicularly on living tissue without injuring the latter, by progressively evolving sodium hydroxid contiguous to said tissue, from and in a moist mixture of calcium hydroxid, sodium carbonate, aluminum sulfate and boric acid ”in a word, this patent apparently was granted for the production ofsodium hydroxid by a chemical reaction which had been in use forseveral centuries because the patentee had twisted the granting ofthis patent into a quasi-endorsement of his nostrum, the councilconsideration of this preparation was sent the patent office as aprotest against the present law which authorizes the granting ofpatents on unproved and improbable medical claims at that time thecouncil was informed by the patent office that reforms in the issuanceof patents for medicinal substances had been instituted, and that “thetrouble will not be so pronounced in the future as it has been in thepast ” flavoring epsom salt a “discovery”there was issued early in 1917 u s patent no 1, 212, 888 for a methodof flavoring epsom salt-- yet this “discovery” is a procedure which hasbeen practiced ever since the cathartic action of this bitter salt hasbeen known not only does the patent describe a process long known tophysicians and pharmacists, but it sets forth claims that the flavoredcathartic salt produced by the process cures flatulency, indigestion, sick and sour stomach, colic and destroys worms in commenting on thispatent the journal of the american medical association june 23, 1917, p 1914 was constrained to remark. “the splendid conception of the framers of our constitution in providing a plan for promoting progress in science and useful arts by granting to inventors for a limited time the exclusive use of their inventions, in exchange for the publication of full knowledge thereof, is being debased no branch of our government is of greater importance to the progress of the country than the patent office, provided that office is intelligently administered when the patent office is used, however, for an extension of the nostrum business, founded on the abuse of patent and trade-mark laws, it becomes a menace to the public health the objects of the patent law are being defeated by the practices of the patent office ”still further, attention is called to u s patent no 1, 226, 394 fora process of making hexamethylenamin tetraiodid and on the product soproduced this patent was issued after the council had notified thepatent office that hexamethylenamin tetraiodid had been discovered in1888 and that a process identical in principle with that for whichpatent application appeared to have been made was published in 1916 on the basis of claims for which no evidence is produced this patentis issued for a well-known substance on the ground that as previouslyproduced it contained a little free iodin or that the known processeswere less economical this patent appears to be an illustration ofour patent procedure which obliged american users of acetylsalicylicacid to pay an exorbitant price because this country granted a patentwhich gave to the patentee, a foreigner, the exclusive right to themanufacture of the substance, whereas no such patent was issued inthe patentee own country nor, so far as we can learn, in any othercountry it forcibly illustrates the need for a revision either of ourpatent laws or of their methods of enforcement or both the beveridge patentin further justification of the council protest against theprovisions of our present law, or the methods of its enforcement, which permit the granting of patents without thorough and scientificinvestigation of the claims advanced in such letters patent, thecouncil calls attention to the report, appearing above, of aninvestigation made by a j carlson, a e kanter and i tumpowski, “the question of the stability of secretin, ” which relates to u s patent no 1, 181, 424, issued to james wallace beveridge whereas the regulations governing the issuance of patents demandthat the processes shall be described in such detail that one versedin the sciences can confirm the claims made by the patentee, nopretense whatever of fulfilling this requirement is made in the patentspecifications of this patent the substance of the first threeparagraphs of this patent has long been general knowledge nearly everysophomore medical student has himself performed, or seen performedsuch “experiments” as are therein described the claims of noveltyevidently are confined to the assertion that the preparation is able to“resist oxidation or deterioration”. That it is free from “poisonousand irritable chemical substances”. That it “may be administered orallyto produce the desired physiological action ” etc , etc not theslightest hint is given as to how any person can substantiate theseclaims as a matter of fact, the investigation of professor carlsonand his co-workers has shown that a preparation having the propertiesclaimed cannot be made by the process described in this patent anyone familiar with the subject could have demonstrated readily that theapplicant was withholding information concerning essential features ofhis process, assuming that he had any information on the subject whichhe probably did not have and would have advised against the issuanceof the beveridge patent -- from the journal a m a , jan 12, 1918 surgodine report of the council on pharmacy and chemistrythe following report submitted by a referee was adopted by the counciland authorized for publication w a puckner, secretary surgodine sharp and dohme, baltimore, md , according to anadvertising pamphlet, is a solution of 2-1/4 per cent of iodin inalcohol, containing no alkaline iodid, but miscible with water in allproportions the a m a chemical laboratory reports that surgodineis an alcoholic liquid containing 91 8 per cent alcohol by volumecontaining free iodin, combined iodin and free acid, probably hydrogeniodid hydriodic acid quantitative estimations gave 2 51 gm freeiodin per 100 c c and 1 78 gm combined iodin the greater writingapparently was present as hydrogen iodid it is therefore similar to several other iodin preparations alreadyconsidered by the council like these, it is essentially similar tothe official tincture of iodin, except that it is considerably weaker, and instead of potassium iodid it presumably contains hydrogen iodidand probably ethyl iodid to render the iodin water-soluble itscomposition, however, is secret there would be no objection to the use of ethyl iodid or hydrogeniodid, except perhaps the acidity of the latter, as a solvent agentrather than of potassium iodid but neither is there any importantadvantage, and these preparations would have to be considered asunessential modifications of official preparations, and thereforeineligible for new and nonofficial remedies the attempt to make these modifications commercially profitable, however, seems inevitably to lead to exaggerations and misstatements in an advertising pamphlet the following claims for surgodine areunsupported by any evidence.

Thestone in the kidneys or bladder, the gravel, and all other pains of thebladder and reins, by taking the roots in powder, or a decoction ofthem in white wine, with a little honey the roots made into powder, and mixed with honey in the form of an electuary, doth much help themwhose stomachs are swollen, dissolving and breaking the wind which wasthe cause thereof. And is also very effectual for all the diseases ofthe lungs, as shortness of breath, wheezing, hoarseness of the throat, and the cough. And to expectorate tough phlegm, or any other writingsthereabout the fig-tree to give a description of a tree so well known to every body that keepit in his garden, were needless they prosper very well in our englishgardens, yet are fitter for medicine than for any other profit which isgotten by the fruit of them government and virtues the tree is under the dominion of jupiter the milk that issues out from the leaves or branches where they arebroken off, being dropped upon warts, takes them away the decoctionof the leaves is excellently good to wash sore heads with. And thereis scarcely a better remedy for the leprosy than it is it clears theface also of morphew, and the body of white scurf, scabs, and runningsores if it be dropped into old fretting ulcers, it cleanses out themoisture, and brings up the flesh. Because you cannot have the leavesgreen all the year, you may make an ointment of them whilst you can adecoction of the leaves being drank inwardly, or rather a syrup madeof them, dissolves congealed blood caused by bruises or falls, andhelps the bloody flux the ashes of the wood made into an ointment withhog grease, helps kibes and chilblains the juice being put into anhollow tooth, eases pain. As also pain and noise in the ears, beingdropped into them. And deafness an ointment made of the juice andhog grease, is an excellent remedy for the bitten of mad dogs, orother venomous beasts as most are a syrup made of the leaves, or greenfruit, is excellently good for coughs, hoarseness, or shortness ofbreath, and all diseases of the breast and lungs. It is also extremelygood for the dropsy and falling sickness they say that the fig tree, as well as the bay tree, is never hurt by lightning. As also, if youtie a bull, be he ever so mad, to a fig tree, he will quickly becometame and gentle as for such figs as come from beyond sea, i havelittle to say, because i write not of exoticks the yellow water-flag, or flower-de-luce descript this grows like the flower-de-luce, but it has much longerand narrower sad green leaves, joined together in that fashion.

“ a cincinnati physician who is now acting assistant surgeon, u s public health service, cooperating with the bureau of venereal diseases of the dewritingment of health of the state of ohio ”3 the right hand top corner of the official stationery, as can beseen by the reproduction, bore the name of “james d bauman, deputycommissioner ” dr broeman signature was rather illegible and couldeasily be mistaken, by those not knowing the handwriting of eitherman, for the signature of deputy commissioner bauman in at least oneinstance it was so mistaken, and the physician who was misled wrote tothe director of the bureau asking whether the testimonial for proteogenno 10 which had been shown him by the merrell detail man was really anofficial communication 4 on may 15, 1919, commissioner of health freeman wrote to themerrell co stating that he had been informed that one of the merrellrepresentatives was using as an advertisement a letter bearing theletterhead of the bureau of venereal diseases of the state dewritingmentof health and what purported to be a report signed by “mr bauman, deputy commissioner ”5 on may 19, the wm s merrell co wrote dr freeman that he wascertainly mistaken in regard to the use of any “report signed bymr bauman ” dr freeman then sent to the company the letter he hadreceived from the physician who had mistaken broeman letter for anofficial letter by bauman although it would seem that this letterand commissioner freeman protest should have made plain to the wm s merrell co , the fact that the letter, incorrectly referred toas mr bauman, was in reality dr broeman, the company remainedsilent regarding its use of the broeman letter and, on may 22, merelyreiterated that there had been “no letter circulated by this companycontaining a testimonial of your mr bauman ” on may 28 six dayslater the merrell company sent to its proteogen tuesdays with morrie essay detail men anothergeneral letter, “for personal use of agents, ” in which it again calledtheir attention to the “photographic copy mounted on linen” of dr broeman letter this communication to the detail men also declaredthat it “has been suggested that the further use of dr broemanletter might antagonize the state dewritingment of health” and, thereforethe detail men were told to “discontinue using the photographic copy inquestion” and to return the photographs to the head office illustration. Reproduction reduced of one of the photographiccopies sent out by the wm s merrell co to its proteogen detail mento be shown to physicians while the letter is a private one, it waswritten without authority on official stationery essay physicianswere misled into thinking it was an official endorsement of proteogens the merrell concern denied any intention to mislead and claimed thatit was interested only in bringing to the attention of physicians thecontents of the letter!. Here, briefly are the bald facts in the case the essential point atissue is whether these photographic copies of dr broeman letterwould or would not be likely-- whether or not they were so intended-- tomislead physicians into believing that the endorsement was an officialone by the state board of health rather than an individual one one canbut wonder why, if, as the merrell company so vehemently asserts, therewas no intention of misleading physicians on this point, the companyshould have gone to the trouble and expense of photographing theentire letter, including the letterhead, rather than making typewrittenor mimeographed copies of the contents of the letter -- from thejournal a m a , sept 27, 1919 dr broeman final report on proteogensto the editor:-- in the september 27 issue of the journal my namewas mentioned in connection with the merrell chemical company“proteogens” in the treatment of syphilis the merrell chemical companypromised not to use my name at any time in connection with their“proteogens” injection and they know that the use of my name has beendistinctly against my wishes i feel that in justice to myself, as wellas the public, i should report the result of my experiments with their“proteogens” in private practice in explanation i might say that i began the use of their “proteogens”in april, 1918, and i feel that i now have enough data to give acomplete report i might say that all my results have been practicallynil. Writingicularly is this true in my paper of syphilis, which all hada four plus wassermann reaction when i discontinued using this form oftreatment very truly yours, c j broeman, m d , cincinnati -- correspondence in the journal a m a , oct 11, 1919 pulvanein a twelve-page pamphlet, sent out by the pulvane laboratories, inc , of des moines, iowa, and purporting to deal with “the therapy ofpulvane, an advanced method for the treatment of respiratory diseases, ”we are told that pulvane “was developed in a united states army generalhospital by officers of the medical dewritingment ”pulvane “originally was intended only for its germicidal actionupon tubercle bacilli in the lung, ” but it is now also recommendedfor asthma, hay fever, bronchitis, rhinitis, laryngitis and “otheraffections of the air passages ” of the alleged action of pulvane ontuberculosis we read. “it destroys the spores of the bacilli as well as the germs themselves it prevents infection of new areas by aspiration, gravity or surface contact “in paper where sputum is positive it is a very noteworthy fact that shortly after treatment is begun, the bacilli begin to disappear, gradually diminish in number, and finally the sputum becomes negative ”pulvane is administered, by inhalation, at the offices of the pulvanelaboratories, inc its “discoverer” chanced on a method of “introducinginto solution and volatizing a certain germicide, extremely rare inits usage because of its resistance heretofore to attempts to bend itto scientific will ” this “rare” medicament is alpha naphthol!. butsince the discovery of this volatizing method “three other ingredientsof high therapeutic value have been added ” what are these otheringredients?. “they would be named were it not that pulvane requires special technique in its preparation and administration our medical directors do not consider it advisable to identify them here because of the possibility of incompetent hands attempting their use the medical directors, however, will be glad to name every ingredient of pulvane for any reputable member of the profession pulvane laboratories reserve only the method of compounding ”presumably, therefore, if physicians desire to know what pulvane is, the pulvane laboratories, inc , “will be glad to name every ingredientof pulvane ” it is worth noting that nothing is said about quantities it is also worth remembering that “peruna” and essay other “patientmedicines” have for years printed on the label the names of thealleged ingredients how much longer is the medical profession going tobe fooled with the trick of nostrum exploiters pretending a franknessthat means nothing?. From a recent issue of a des moines newspaper we learn that the pulvanelaboratories are about to establish a sanatorium where the pulvanetreatment can be given this announcement is said to be made by john p mosher, the alleged discoverer of pulvane mosher is not a physician the newspaper article states, further, that mosher experiments weretried out “under the observation of major sharpe, ” commander at fortdes moines it appears also that an ex-newspaper reporter is connectedwith the pulvane laboratories the value of having a good publicityman is obviously recognized there also seems to be connected with theconcern a dr harry p hall we find in the records reference to oneharry p hall who was graduated by the medical dewritingment of drakeuniversity of des moines, iowa, in 1894, and was licensed in iowa in1896 our records indicate that he has not been in practice for essayyears we also find in our files essay newspaper clippings regarding adr harry p hall who, in 1914, pleaded guilty to a charge of using themails to defraud and was fined in the federal courts whether there isany connection between these two names, we do not know reverting to the claims made by the pulvane laboratories that pulvanewas “developed in a united states army general hospital by officersof the medical dewritingment” the following statement has recently beenreceived by the journal from surgeon-general ireland of the unitedstates army. “it has been brought to my attention that a concern in des moines, iowa, known as the pulvane laboratories, has issued a pamphlet in which statements are made which would naturally lead medical men to believe that the experiments, etc , referred to therein were made with the approval of and more or less under the direction of the medical dewritingment of the army i wish to say that this is not so. That the medical dewritingment had nothing whatever to do with the matter and that it thoroughly disapproves of the methods used by the promoters of this concern -- from the journal a m a , march 11, 1922 sal hepaticasal hepatica is a saline laxative sold by the bristol-myers company ofnew york little information is given, or, apparently, ever has beengiven, concerning the composition of this product thesis years ago thestock medical journal advertisement contained this statement. “composition -- sal hepatica contains all of the tonic, alterative and laxative salts of the celebrated ‘bitter waters’ of europe, especially those of bohemia, as determined by actual chemical analysis of these waters, and fortified by the addition of lithium and sodium phosphates ”255255 essay of the sal hepatica advertising has claimed that it “is asaline combination with the addition of sodium phosphate and lithiacitrate!. ”sal hepatica no longer “contains all the tonic, alterative and laxativesalts , ” etc , for the label on a package recently purchased reads. “sal hepatica is an effervescent saline combination possessing medicinal properties similar to the natural ‘bitter waters’ of europe, and fortified by the addition of sodium phosphate ”in 1909, the druggists circular published an analysis of sal hepaticawhich showed that the preparation contained only 0 04 per cent oflithium phosphate by referring to the two quotations just givenit will be noticed that today the manufacturers make no claim thattheir preparation is fortified with any salt of lithium a circularaccompanying recent trade packages states. “sal hepatica is composed solely of harmless salts, being absolutely free from acetanilid, phenacetin, caffein, calomel, opium or coal tar derivatives ”since neither the names nor the amounts of the “harmless salts” arementioned, the composition of sal hepatica is secret it is a trickof the nostrum exploiter, old but ever popular, to mention numerousdrugs which his preparation does not contain. It helps to distractattention from the fact that he does not tell what the preparationdoes contain!. In the old-time medical journal advertisements, one reads, “salhepatica is the most powerful solvent of uric acid known ” the sameadvertisement as it appeared in those days in the journal showsthat claim toned down to, “sal hepatica is a powerful solvent ofuric acid ” in those easy going days, the bristol-myers companydeclared that “diabetes is treated with decided advantage by meansof sal hepatica it possesses the property of arresting thesecretion of sugar in the liver ” in the old days, too, sal hepaticawas recommended in the treatment of cirrhosis of the liver, brightdisease, gravel, phthisis, etc the present advertising circular recommends sal hepatica as aneliminant, laxative or cathartic in gout, autointoxication, “biliousattacks, ” rheumatism, acute indigestion, catarrhal conditions ofthe stomach, pyorrhea, headache, dizziness, heart burn, “summercomplaints, ” “derangements of the stomach and liver, ” skin diseases, colic, alcoholic excesses, and as a “preventive of seasickness ”in 1914 the council on pharmacy and chemistry published256 a reporton sal hepatica declaring it secret in composition and sold underexaggerated and unwarranted claims 256 j a m a , feb 7, 1914, p 472 in view of the inquiries which the journal continues to receive itseemed worth while to make a chemical examination of the present-dayproduct accordingly specimens were purchased and analyzed in thea m a chemical laboratory the report that follows was submitted bythe chemists:“sal hepatica is a white, granular, odorless powder it effervesces onthe addition of water in which it eventually dissolves the aqueoussolution, after boiling to remove carbon dioxid, has an acid reactionto litmus “since a great thesis medicinal substances are sold in effervescent form, and since practically no information is given by the manufacturerconcerning the composition of sal hepatica, it became necessary totest for a considerable number of therapeutic agents the absence ofacetanilid, acetphenetidin, alkaloids, ammonium salts, benzoates, caffein, citrates, heavy metals, hexamethylenamin, magnesium, potassium, salicylates and sugars was demonstrated by appropriatetests the presence of a carbonate probably in the form of abicarbonate, a phosphate, a sulphate, a chlorid, tartaric acid, sodiumand traces of lithium was shown by qualitative tests “quantitative analysis indicated that the composition of the specimensexamined was essentially as follows.

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That, in the opinionof the council, tuesdays with morrie essay mon-arsone should not be used except under conditionsthat justify the experimental trial of an unproved drug, and should notbe used in a routine way until the permanence of its effects has beenestablished. And consequently any advertising propaganda for the drugby the harmer laboratories company was to be deprecated in its reply the harmer laboratories company admitted that itsadvertising claim, that mon-arsone was at least equal to arsphenaminetherapeutically, had been based on reports on fifty paper and onadditional reports that were beginning to come in at that time the harmer laboratories company submitted a list of hospitals andphysicians using mon-arsone a letter of inquiry sent by the council tothose who, according to the names in the list supplied by the harmerlaboratories company, had used mon-arsone, brought seven replies the clinical evidence contained in these replies was to the effect thatmon-arsone had been used in the various types of syphilis and thatthere was a certain beneficial effect, both clinically and as shown bythe wassermann reaction in certain instances the wassermann reactionchanged from a four plus to a negative reaction the reports showedthat the efficiency of mon-arsone as compared with that of arsphenaminepreparations has not been adequately studied one physician who hasused mon-arsone extensively reports that in thesis of the paper treatedthere seemed to be nearly as good results from the use of mon-arsone asis frequently obtained in the use of arsphenamine he reports, however, that it was necessary in eleven out of one hundred paper to change frommon-arsone to neoarsphenamine in view of the fact that there is definite lack of evidence to showthat mon-arsone is the equal of arsphenamine therapeutically, andbecause of the reports that in essay paper it is inferior, mon-arsoneshould not be used in the treatment of syphilis generally until itstherapeutic status has been more rigidly investigated and conclusiveevidence of its superiority to arsphenamine preparations obtained the council voted not to admit mon-arsone to new and nonofficialremedies and reaffirmed its conclusion that the claim that mon-arsonehas a therapeutic value equal to that of arsphenamine is premature andunwarranted. That mon-arsone should not be used except under conditionsthat justify the experimental trial of an unproved drug.